Document Detail


Replacement of obstructed right ventricular-pulmonary arterial valved conduits with nonvalved conduits in children.
MedLine Citation:
PMID:  4028369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Six to thirty percent of right ventricular-to-pulmonary arterial (RV-PA) valved conduits in children fail within 5 years. Experience with correction of tetralogy of Fallot has shown that a competent pulmonary valve is not essential for excellent late results in most patients. Between March 1980 and November 1984, 26 patients who were 12.5 +/- 3.3 years old underwent conduit replacement 6.7 +/- 2.4 years after definitive repair of congenital heart defects in which a xenograft RV-PA valved conduit had been used. A new Dacron tube graft (n = 15) or pericardial (n = 8), dura mater (n = 2), or Dacron patch (n = 1) over the previous conduit bed was used as replacement. Preoperative mean right ventricular systolic pressure was 90.5 +/- 20 mm Hg and mean gradient across the conduit was 67.9 +/- 24.5 mm Hg. After replacement with a nonvalved conduit, right ventricular systolic pressure was reduced to 45.2 +/- 10.8 mm Hg (p less than .001), with a gradient of 8.9 +/- 7.6 mm Hg (p less than .001). There were no operative deaths. Follow-up at 19.5 +/- 14.9 months (range = 0 to 53) showed that all patients were in New York Heart Association class I (n = 21) or class II (n = 5). In the absence of pulmonary hypertension, hypoplastic pulmonary arteries, significant right ventricular dysfunction, or unrepaired tricuspid regurgitation, replacement of an obstructed conduit with a nonvalved conduit gives excellent early results and may diminish the need for late reoperation.
Authors:
T P Downing; G K Danielson; H V Schaff; F J Puga; W D Edwards; D J Driscoll
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  72     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1985 Sep 
Date Detail:
Created Date:  1985-10-03     Completed Date:  1985-10-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  II84-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Pressure
Child
Child, Preschool
Follow-Up Studies
Heart Valve Prosthesis* / adverse effects
Heart Ventricles / abnormalities,  surgery*
Humans
Intraoperative Period
Pulmonary Artery / surgery*
Pulmonary Valve / surgery*
Reoperation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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